Echocardiographic Assessment of Prosthetic Valves

Ashraf, Hasan; Freeman, William K.

doi:10.31083/j.rcm2310343

Cited by 2 publications

(2 citation statements)

References 77 publications

(87 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…TTE can define abnormal valvular hemodynamics, but TEE is superior in clarifying the precise etiology responsible for valve dysfunction [ 10 ]. An algorithmic approach has been suggested when evaluating mitral valve prosthesis with echocardiography.…”

Section: Discussionmentioning

confidence: 99%

Successful Reversal of Late, Severe Thrombotic Bioprosthetic Mitral Valve Stenosis With Anticoagulation Therapy

Galtes,

Gomez,

Sarria Arbocco

2024

Cureus

View full text Add to dashboard Cite

Late bioprosthetic valve thrombosis (bPVT) is a rare and potentially life-threatening complication following valve replacement with thrombus formation leading mostly to valvular stenosis or embolic phenomena. Clinically, it manifests as symptoms of fatigue, dyspnea, or reduced exercise capacity. The existing treatment guidelines lack clear recommendations for managing this specific presentation. In this case study, we present a distinct clinical scenario wherein the use of anticoagulation, specifically apixaban, successfully reversed very late, severe thrombotic stenosis in a 78-year-old woman with a Medtronic Hancock II porcine mitral valve (Dublin, Ireland). This case highlights the need to consider bPVT as an alternative etiology to valve degeneration in the setting of late bioprosthetic valve stenosis. Additionally, it demonstrates how apixaban therapy may serve as a viable treatment modality in these scenarios.

show abstract

Section: Discussionmentioning

confidence: 99%

Successful Reversal of Late, Severe Thrombotic Bioprosthetic Mitral Valve Stenosis With Anticoagulation Therapy

Galtes,

Gomez,

Sarria Arbocco

2024

Cureus

View full text Add to dashboard Cite

show abstract

“…The hemodynamic profile of normally functioning stented AV protheses resembles that of mild native aortic stenosis with slightly elevated mean transvalvular gradients and peak transvalvular velocities. 20,21 In contrast, native valve-preserving procedures offer the potential benefit of postoperative transvalvular hemodynamics similar to those of wellfunctioning native valves due to the absence of a rigid stent and sewing ring and preserved native aortic root geometry allowing for preserved transvalvular flow characteristics and LV dynamics. 22 Romeo et al reported excellent hemodynamics across the autograft following the Ross procedure in an international multicenter study of 1,063 patients.…”

Section: Commentmentioning

confidence: 99%

Hemodynamics and Diastolic Function after Native Aortic Valve Preserving vs. Replacing Surgery

Holst,

Hua,

Sinning

et al. 2023

Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Background Alterations in left ventricular (LV) diastolic function following native tissue-preserving aortic valve (AV) procedures have not been systematically investigated. Furthermore, no comparisons have been made between these changes and those observed after prosthetic AV replacement. Methods From October 2017 to August 2020, 74 patients aged <65 years were referred to our institution for elective AV surgery. Preoperative and postoperative (i.e., discharge, 3-months and 1-year follow-up) transthoracic echocardiography was analyzed. Results Native tissue-preserving surgery was performed in 55 patients (AV repair: n=42, Ross procedure: n=13). The remaining 19 patients underwent prosthetic AV replacement. Preoperatively and at discharge, transvalvular hemodynamics and LV diastolic function were comparable in both groups. At 1-year follow-up, native valve patients showed significantly lower mean transvalvular gradients (7±5 vs. 9±3 mmHg,p=0.046) and peak velocity (1.74±0.51 vs. 2.26±0.096 m/s,p=0.004) and significantly better septal e’ (9.1±2.7 vs. 7.7±2.5 cm/s,p=0.043) and lateral e’ (14.7±3.1 vs. 11.7±3.7 cm/s,p=0.001). From preoperatively to 1 year postoperatively, septal and lateral e’ and E/e’ improved markedly after native valve preservation (septal e’: +0.7 cm/s,p=0.075; lateral e’: +2.3 cm/s,p<0.001; E/e’: -1.5,p=0.001) but not after AV replacement (septal e’: +0.2 cm/s,p=0.809; lateral e’: +0.8 cm/s,p=0.574; E/e’: -1.2,p=0.347). Significant negative linear correlations between postoperative transvalvular gradients and absolute changes in lateral e’ and E/e’ were detected during follow-up. Conclusion Preservation of native tissue in AV surgery results in superior transvalvular hemodynamics compared to prosthetic AV replacement. This may induce faster LV reverse remodeling and may explain more pronounced improvement in LV diastolic function.

show abstract

Echocardiographic Assessment of Prosthetic Valves

Cited by 2 publications

References 77 publications

Successful Reversal of Late, Severe Thrombotic Bioprosthetic Mitral Valve Stenosis With Anticoagulation Therapy

Successful Reversal of Late, Severe Thrombotic Bioprosthetic Mitral Valve Stenosis With Anticoagulation Therapy

Hemodynamics and Diastolic Function after Native Aortic Valve Preserving vs. Replacing Surgery

Contact Info

Product

Resources

About